The scale of the challenge faced by NHS organisations to break even was reaffirmed yesterday as one health board admitted it could overspend by even more than its worst case scenario.

The scale of the challenge faced by NHS organisations to break even has been reaffirmed as one health board admitted it could overspend by even more than its worst case scenario.

Health chiefs from Betsi Cadwaladr University Health Board said their overspending for the year could be up to £24m - an increase from the £19m worst case scenario forecasted in the Auditor General’s report last month.

The report, which painted a stark picture of NHS finances, predicted that the health service in Wales could end up £70m in the red at the end of the financial year, but in the worst case scenario this figure could reach as much at £131m.

Officials from the North Wales based health board said they were working hard to make necessary savings and said they did not envisage reaching the £24m figures.

Geoff Lang, former acting chief executive and executive director of primary care, said: “We still envisage our positing to be at £19m at this time and we are working very hard to manage that but it could be up to £24m if we don’t manage the risks. We are in dialogue with the Welsh Government to ensure we deliver that £19m and below.

“If all the risks were to move in the wrong direction it could drift but we don’t envisage that being the case because we are managing those risks. Our worst exposure probably is about £24m. There are ways we can drive costs down that does not impact on service. Service changes will become more and more important as we year-on-year make savings but there is a lot we can do on effectiveness as well as the service model.”

The admission came as senior members of both Betsi Cadwaladr and Cardiff and Vale University Health Boards were grilled about their finances by the National Assembly’s Health and Social Care Committee.

Mary Burrows, chief executive of Betsi Cadwaladr UHB, said: “We knew that last year was challenging and we knew that coming into this year was going to be even more difficult.

“We have not been as good on our workforce saving as we wanted to be. It’s important that we have a stable workforce in order to keep services safe. We do keep a really good eye on quality of care. Where we do get concerns we step in very quickly and if that means putting in extra resource to stabilise a service then that is what we have done because the safety of the patient is paramount.”

Last month, the chief executive of the NHS in Wales, David Sissling, said there was a £50m contingency fund in place which could be used to help struggling health boards.

Ms Burrows admitted that they may have to look to this fund for support but would continue to work hard with the intention of achieving their statutory duty to break even.

She said: “I suppose we could recognise that there will be opportunity for resources. We will try to get below £19m but unfortunately if we have to borrow into the next year we will do that but with a very heavy heart.”

Meanwhile, chief executive of Cardiff and Vale UHB, Adam Cairns, said he did not underestimate the scale of the challenge.

He said: “We have an enormous challenge on our hands for the current year. In September it was clear we are facing an unfilled gap half way of around £37.5m. But we can change our way out of this.

“We are determined to get ourselves back into a full recurring position. I’m not walking away from the responsibility I have and we are working hard to repair the position. It’s an ongoing task as there is lots of work to close that gap. There are risks to our position but we have been flagging those risks consistently with the Welsh Government. We are committing ourselves to doing everything we can to rectify this position.

“We are now aware there’s been the mid-year review and we understand there is a contingency, which sounds like prudent management to me.”#

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